• History of recurrent urinary tract infections
• Low-grade or subtle symptoms may include:
  • Low back pain
  • Perineal or pelvic floor pain
  • Testicular pain
  • Pain and burning with urination
  • Pain with ejaculation
  • Pain with bowel movement
• Recurrent low-grade fever
• Pain on urination
• Decreased urinary stream
• Urinary hesitancy (delayed start of urination)
• Frequent urination
• Blood in the urine
• Incontinence

A physical examination may reveal an enlarged, mildly tender prostate. The examination may reveal enlarged or tender lymph nodes in the groin area, scrotal swelling and tenderness, and a urethral discharge.

Triple-void urine specimens may be collected for urinalysis and urine culture:

• #1 -- initial stream
• #2 -- midstream
• #3 -- after prostatic massage by examiner

A urinalysis reveals increased white blood cells (WBCs) and bacterial growth upon culture of urine #3. Culture of prostatic secretions shows in increased levels of WBCs and more concentrated bacterial growth.

A semen analysis may also show increased numbers of white blood cells and decreased numbers of sperm, with poor motility.